3. Enzyme preparations. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Classification: proteolytic (trypsin, chymotrypsin), fibrinolytic (fibrinolysin, streptolyase), depolymerization agents (ribonuclease, deoxyribonuclease), which reduce the viscosity of hyalurones to-you (lidase, ronidase), "immobilized" enzymes (streptoferinated coxalavate) ), digestive (pepsin, festal, pancreatin, mezim-forte), inhibitors of proteolytic enzymes (pantripin, ingitril).

Trypsin is an endogenous enzyme that breaks peptide bonds in a protein molecule. Breaks down necrotic tissue, liquefies secretions, exudates, blood clots; anti-inflammatory effect. Used for pulmonary diseases, thrombophlebitis, periodontal disease, osteomyelitis, sinusitis. Side effects - increased t, tachycardia, allergies. Cannot be used for heart and respiratory failure, liver cirrhosis, hepatitis, kidney disease, endophytic cancers.

Fibrinolysin - dissolves fibrin strands. Used for fresh thrombosis, thromboembolism of the pulmonary artery, brain, heart attack, thrombophlebitis. Side effects - hemorrhages, allergies, chest pain, chills, increased t. It is impossible

apply for bleeding, open wounds, peptic ulcer, radiation sickness, hypertension.

Ribonuclease - depolymerizes RNA, liquefies pus, phlegm, anti-inflammatory effect, inhibits the multiplication of RNA-containing viruses. Indications, side effects, contraindications like trypsin.

Deoxyribonuclease - with neuritis of the facial nerve.

Lidase, ronidase - contains hyaluronidase. Used for scars, hematomas. Side effects are allergies. Cannot be used for cancer, infections.

Streptodecase - has a prolonged fibrinolytic effect. Used for thrombosis. Side effects are allergies. Do not use for ulcers, bleeding, acute streptococcal infection, acute inflammation of diseases, pregnancy, hypertension, cancer.

Pantripine, ingitril - inhibits trypsin, etc. Used in acute pancreatitis.

4. The concept of antiseptic and disinfecting action. Conditions that determine the antimicrobial activity of drugs. Nitrofuran derivatives. Classification. Mechanism of action. The nature of the action. Spectrum of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Disinfecting action is the action of drugs aimed at destroying pathogens in the external environment (neutralizing patient care items, rooms, clothing).

Antiseptic action is the action of drugs aimed at pathogens on the surface of the human body (skin, mucous membranes, wounds).

Conditions that determine the antimicrobial activity of drugs:

- establishing an accurate bacteriological diagnosis, establishing the sensitivity of a microorganism to various drugs.

- early start of treatment.

- creation and maintenance of a constant effective concentration of the antimicrobial drug in the body.

- it is desirable to use antimicrobial agents in combination (preventing the development of resistance).

- correct determination of the duration of treatment.

- in the complex of treatment, use means that increase the body's resistance (vitamins, serums).

Nitrofurans

Furadonin, Furagin, Furazolidone, Furacilin,

Nifuroxazide (enterofuril), Nifuratel (makmiror)

The nature of the action - bactericidal

Mechanism of action - violation of protein synthesis

Spectrum of activity - wide

Gr (+) cocci: streptococci, staphylococci (except MRSA),

enterococci are insensitive

Gr (-) coli: E. coli, salmonella, shigella, klebsiella, enterobacteria

The simplest: lamblia, Trichomonas (furazolidone, nifurantel), amoeba (nifurantel)

Resistant anaerobes, Pseudomonas aeruginosa, Proteus, Serrata, acinetobacters

Nitrofuran resistance is rare.

Furadonin and furagin create high concentrations in the urine, while the antimicrobial activity increases with an acidic reaction of urine and weakened - with an alkaline